Author(s): Gong TT, Hu DM, Zhu Q
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Abstract BACKGROUND: Distinguishing pancreatic adenocarcinomas from other pancreatic masses remains challenging with current imaging techniques. Contrast-enhanced EUS further improved the efficacy of EUS to characterize pancreatic lesions. OBJECTIVE: To assess the accuracy of contrast-enhanced EUS for diagnosing adenocarcinoma in patients with pancreatic masses by pooling data of existing trials. DESIGN: We systematically searched the Medline, PubMed, Web of Science, Embase, and Cochrane Central Trials databases for relevant studies published. Meta-analysis was performed. Pooling was conducted in a fixed-effect model or a random-effects model. PATIENTS: Twelve studies involving 1139 patients were included. INTERVENTION: Contrast-enhanced EUS. MAIN OUTCOME MEASUREMENTS: Meta-analysis and meta-regression analysis. RESULTS: The pooled sensitivity of contrast-enhanced EUS for the differential diagnosis of pancreatic adenocarcinomas was 94\% (95\% CI, 0.91-0.95), and the specificity was 89\% (95\% CI, 0.85-0.92). The area under the curve under summary receiver operating characteristic was 0.9732. The pooled positive likelihood ratio was 8.09 (95\% CI, 4.47-14.64), and the negative likelihood ratio was 0.08 (95\% CI, 0.06-0.10). The subgroup analysis by exclusion of the outliers provided a sensitivity of 93\% (95\% CI, 0.91-0.95) and a specificity of 93\% (95\% CI, 0.89-0.95) for the differential diagnosis of pancreatic adenocarcinomas. The area under the curve under summary receiver operating characteristic was 0.9745. LIMITATIONS: A small number of studies met the inclusion criteria. CONCLUSION: Contrast-enhanced EUS is a promising, reliable modality for the differential diagnosis of pancreatic adenocarcinoma in patients with pancreatic mass lesions. The finding of a hypoenhanced lesion was a sensitive and accurate predictor of pancreatic adenocarcinomas. It seems to be a useful tool in clinical practice. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
This article was published in Gastrointest Endosc
and referenced in Pancreatic Disorders & Therapy